ObjectiveTo explore the practical effect of standardized management path for inpatients with chronic and difficult-to-heal wounds.MethodsThe inpatients with chronic and difficult-to-heal wounds in People’s Hospital of Deyang City from July 2015 to June 2019 were collected. According to the random number table, the patients were divided into control group and intervention group. The control group were given routine management and the intervention group were given standardized management. Skin symptoms, Visual Analogue Scale (VAS), wound healing time, length of hospital stay, efficacy, complications, satisfaction and scar hyperplasia were recorded and compared.ResultsA total of 605 patients were included. There were 314 cases in the control group and 291 cases in the intervention group. Before treatment, there was no significant difference in skin symptom score or VAS score between the two groups (P>0.05); after treatment, the skin symptom scores and VAS scores of the two groups decreased (P<0.05), and the scores in the intervention group were lower than those in the control group (P<0.05). The wound healing time [(24.21±1.42) vs. (18.59±1.63) d; t=45.301, P<0.001] and length of hospital stay [(26.97±1.54) vs. (20.03±1.42) d; t=57.492, P<0.001] in the intervention group were shorter than those in the control group. All patients were followed up. The total effective rate (χ2=3.911, P=0.048) and satisfaction (χ2=4.340, P=0.037) of the intervention group were higher than those of the control group. The degree of scar hyperplasia (Z=4.913, P<0.001) and the incidence of complications (P=0.039) of the intervention group were also lower than those of the control group.ConclusionsThe standardized management of hospitalized patients can significantly shorten the chronic and difficult-to-heal wounds healing time, reduce the occurrence of complications, improve the patient’s satisfaction and prognosis. It is worthy of clinical application.
目的 探讨可调节负压引流技术结合植皮治疗皮肤缺损伴感染创面的临床效果及护理要点。 方法 对2008年5月－2011年5月收治的106例皮肤缺损伴感染创面患者，采用间歇负压引流治疗3～10 d，负压值设为50～120 mm Hg（1 mm Hg=0.133 kPa），创面达到Ⅱ期植皮条件时，采用大张、网状或邮票状皮片覆盖创面，继续采用持续负压引流治疗3～12 d，负压值设为50～60 mm Hg，同时进行患者心理和可调节负压引流技术创面等护理。 结果 56例大张皮片植皮中，2例皮片出现0.5 cm×1 cm～0.8 cm×1.2 cm皮片坏死；21例邮票状植皮者，1例出现皮片移动皱缩。除5例骨外露，先通过植皮创面缩小后行皮瓣转移，101例创面愈合时间7～25 d，平均14 d，无因所植皮片未成活需再次植皮和因感染死亡或截肢。 结论 可调节负压引流技术结合植皮治疗皮肤缺损伴感染创面，可有效控制感染，减轻患者换药痛苦，减少医务人员换药和护理工作量，加快植皮创面愈合，缩短创面治愈时间。
目的 观察可调节负压引流技术联合局部氧疗治疗腹部切口感染创面的临床效果。 方法 对2009年5月－2012年9月28例腹部切口感染创面患者使用可调节负压引流技术联合局部氧疗治疗，创口内填入负压吸附垫，持续输氧0.5～1 L/min，可调节负压采用连续工作模式，使密闭创面保持60～120 mm Hg（1 mm Hg=0.133 kPa）的负压状态，3～7 d更换负压吸附垫和引流管。 结果 28例切口创面感染得到控制。8例经一次治疗创面愈合，15例经2～4次治疗创面愈合，2例行Ⅱ期缝合，3例患者对贴膜过敏，治疗一次后改为换药治疗。28例患者创面愈合时间4～28 d，平均14 d，随访1～18个月无切口裂开，7例有凹陷瘢痕，余瘢痕平整。 结论 可调节负压引流技术联合局部氧疗治疗腹部切口感染创面，具有操作简便、安全可靠、疗效明显的优点，可加快创面愈合，缩短住院时间，提高切口的愈合质量，减轻患者痛苦及医务人员的工作量。